<div class="main"> 
 <div class="banner"> 
  <img src="/resources/front/template/nbo/images/banner-contact.jpg" alt="Contact Us" /> 
  <h1>Contact Us</h1> 
 </div> 
 <article class="middle wide"> 
  <h2>Contact Us</h2> 
  <form action="/nbo-enquiry/create/" method="POST">
  <table class="formT" > 
   <tbody> 
    <tr> 
     <th><span class="asterisk">*</span>Name:</th> 
     <td><input type="text" name="name" /></td> 
     <th><span class="asterisk">*</span>Email:</th> 
     <td><input type="text" name="email" /></td> 
    </tr> 
    <tr> 
     <th>Company:</th> 
     <td><input type="text" name="company" /></td> 
     <th><span class="asterisk">*</span>Phone:</th> 
     <td><input type="text" name="phone" /></td> 
    </tr> 
    <tr> 
     <th colspan="4"><span class="asterisk">*</span>How did you hear about us?</th> 
    </tr> 
    <tr> 
     <th></th> 
     <td colspan="3" class="radioGp"> <label><input type="radio" name="how" />Referral 
       <div class="inputExtra" style="width:370px;"> 
        <table> 
         <tbody> 
          <tr> 
           <th><span class="asterisk">*</span>Name of Referrer</th> 
           <td><input type="text" name="nameRefferrer" /></td> 
          </tr> 
          <tr> 
           <th>Company of Referrer</th> 
           <td><input type="text" name="companyReferrer" /></td> 
          </tr> 
         </tbody> 
        </table> 
       </div> </label> <label><input type="radio" name="how" />Social media</label> <label><input type="radio" name="how" />Internet search</label> </td> 
    </tr> 
    <tr> 
     <th></th> 
     <td colspan="3" class="radioGp"> <label><input type="radio" name="how" />Online News sites</label> <label><input type="radio" name="how" />Newspapers/Magazines</label> <label><input type="radio" name="how" value="Other" />Other <input type="text" name="" class="inputExtra" /> </label> <script>
				$(".radioGp label").click(function() {
				  $(".inputExtra").hide();
				  $(this).children(".inputExtra").show();
				});
			</script> <br /><br /><br /> </td> 
    </tr> 
    <tr> 
     <th><span class="asterisk">*</span>Topic:</th> 
     <td colspan="3"> <select name="topic"> <option>Topic 1</option> <option>Topic 2</option> <option>Topic 3</option> </select> </td> 
    </tr> 	
    <tr> 
     <th>Subject:</th> 
     <td colspan="3"><input type="text" name="subject" /></td> 
    </tr> 
    <tr> 
     <th><span class="asterisk">*</span>Message:</th> 
     <td colspan="3"><textarea name="message"></textarea></td> 
    </tr> 
    <tr> 
     <th></th> 
     <td><input type="submit" value="Send Enquiry &raquo;" name="" class="btn" /></td> 
    </tr> 
   </tbody> 
  </table> 
  </form>
 </article> 
 <!-- end middle --> 
 <div class="right"> 
  <div class="map"> 
   <iframe width="250" height="200" frameborder="0" scrolling="no" marginheight="0" marginwidth="0" src="https://maps.google.com/maps?f=q&amp;source=s_q&amp;hl=en&amp;geocode=&amp;q=singapore+238884&amp;sll=37.0625,-95.677068&amp;sspn=45.957536,87.626953&amp;ie=UTF8&amp;hq=&amp;hnear=Singapore+238884&amp;t=m&amp;z=14&amp;ll=1.306137,103.829596&amp;output=embed"></iframe> 
   <br /> 
   <small><a href="https://maps.google.com/maps?f=q&amp;source=embed&amp;hl=en&amp;geocode=&amp;q=singapore+238884&amp;sll=37.0625,-95.677068&amp;sspn=45.957536,87.626953&amp;ie=UTF8&amp;hq=&amp;hnear=Singapore+238884&amp;t=m&amp;z=14&amp;ll=1.306137,103.829596">View Larger Map</a></small> 
   <br /> 
   <br /> 
  </div> 
  <div class="rightInfo"> 
   <strong>Address:</strong> 
   <br /> 583 Orchard Road, #10-04 Forum 
   <br /> Singapore 238884 
   <br /> 
   <br /> 
   <strong>Phone:</strong> (65) 6339 8733 
   <br /> 
   <strong>Fax:</strong> (65) 6339 7055 
   <br /> 
   <strong>E-mail:</strong> feedback@nbogroup.com 
  </div> 
 </div> 
 <!-- end right --> 
</div>